VIDEO: Physician discusses distinct factors of NAFLD in pediatric patients
WASHINGTON — In this exclusive video from Emerging Trends in Non-Alcoholic Fatty Liver Disease, Joel E. Lavine, MD, PhD, FAASLD, of the department of pediatrics at Columbia University Medical Center in New York, discusses the distinct factors of pediatric fatty liver disease.
“I believe this is a topic of utmost importance for the field of non-alcoholic fatty liver disease because children are the most vulnerable in terms of those that have apparent genetic predisposition or susceptibility to environmental influences,” Lavine said. “The ones that are picked up the soonest are the most likely to have to live with the burden of fatty liver disease the longest and perhaps have the worst complications as young adults or beyond.”
Lavine stated that the importance of studying children with NAFLD is related to the fact that they have not yet been subject to other influences, such as alcohol, which may obscure pathogenetic analysis. Additionally, children have a pattern that is often distinct from adults, as they typically have more fat, less lobular inflammation, more portal inflammation, less fibrosis in the perisinusoids and more fibrosis in the portal track.
Lavine also discusses the National Institute of Diabetes and Digestive and Kidney Diseases sponsored clinical trials that evaluated the efficacy of daily vitamin E doses of 800 units for 96 weeks in adults (PIVENS) and children (TONIC).
“Both of those trials demonstrated that vitamin E at that dose once a day for 96 weeks was effective in reaching the primary endpoint in PIVENS of improvement of histology,” Lavine said. “And in children, that was a secondary endpoint, but also demonstrated the same positive effect in terms of resolution of NASH and in terms of decreasing NAFLD activity score relative to those treated with placebo for 96 weeks.”
Disclosure: Lavine reports he is an advisor for Janssen and a consultant for Merck, Pfizer and Prestige Brands.